Kondo C, Okabe M, Hata H
Department of Cardiovascular Surgery, Hamamatsu Medical Center, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Apr;43(4):562-6.
A 46-year-old woman was hospitalized with congestive heart failure. She had undergone a mitral valve replacement (23 mm) 17 years earlier and complicated a left ventricular rupture. Upon admission, she was diagnosed with aortic and mitral stenoinsufficiency with narrowed annuli on both valves, tricuspid insufficiency, and a left ventricular pseudoaneurysm. The operative procedure consisted of enlarging the aortic and mitral valve rings and replacing them by the coupling valve method. The orifice of the pseudoaneurysm was repaired with a patch closure applied from the endocardial side. A tricuspid annuloplasty was performed using the DeVega's method. Her postoperative course was uneventful. This is the first report of a successful operation to correct double narrowed annuli along with a ruptured left ventricule. The coupling valve procedure employed here should prove useful for similar cases requiring enlargement and replacement of the aortic and mitral valves simultaneously.
一名46岁女性因充血性心力衰竭入院。她17年前接受了二尖瓣置换术（23毫米），并发左心室破裂。入院时，她被诊断为主动脉瓣和二尖瓣狭窄关闭不全，两个瓣膜瓣环狭窄，三尖瓣关闭不全，以及左心室假性动脉瘤。手术过程包括扩大主动脉瓣和二尖瓣瓣环，并采用耦合瓣膜法进行置换。假性动脉瘤的开口从心内膜侧用补片修补。使用德维加法进行三尖瓣环成形术。她术后恢复顺利。这是第一例成功纠正双瓣环狭窄并伴有左心室破裂的手术报告。这里采用的耦合瓣膜手术对于需要同时扩大和置换主动脉瓣和二尖瓣的类似病例应该是有用的。
